After Laura Bushman Schneider's father died three years ago, she started to worry about her mother, who was living alone for the first time and showing signs of mild cognitive impairment. Schneider, who lives near her mother in Long Island, has good relationships with her two sisters and brother, but they're scattered around the country — in New Jersey, Maine and California.
That made it challenging to share the responsibilities of caring for their older mother, and tensions rose as they argued over whether she should be moved to an assisted living facility.
"There was so much worry, concern and frustration on their part," Schneider says of her siblings. "I didn't realize at the time that they felt they didn't have any input, even though we talked pretty regularly."
"A good mediator is truly neutral and non-judgmental."
So Schneider and her siblings decided to hire a family mediator in September. By October, they had all agreed to move their mom to assisted living, selected a facility and worked together to prepare her for the move. They each volunteered for tasks like helping their mom sort out her finances and coaxing her to give up driving.
"We were able to put a plan in place for each person to have a specific job," Schneider says. Mediation, she adds, allowed she and her siblings and "to voice our opinions and concerns without getting emotional."
When people hear the term "mediation," they often associate it with legal disputes, but you don't have to be squabbling over power of attorney or other legal issues to benefit from the process. Many mediators specialize in helping families resolve disagreements over elder care, facilitating discussions among siblings and sometimes other family members in a process designed to lead to a peaceful solution.
"A good mediator is truly neutral and non-judgmental," says Gail Goodman of Talking Alternatives, the Westchester, N.Y.-based mediation firm that Schneider and her siblings used. "We're vested in helping people avoid litigation."
Allowing All Voices to Be Heard
Mediators typically start the process by talking to each member of the family separately. That may include the elder parent, too, provided he or she has the desire and capacity to participate. From there, all family members will meet with the mediator via video conference, during which they will be guided through a structured discussion.
"Mediation offers an opportunity to have that conversation right away and make a decision."
"There are rules for making it a safe space," says Andrea Pezel, an elder expert for Grayce, a caregiver-support firm in San Francisco that offers family mediation services through employers. "We make sure everyone has a chance to speak and that it's about identifying problems, more so than pointing blame."
The goal is to end up with a list of "action items," Pezel says, like gathering legal documents or setting up doctor's appointments, and for each family member to be assigned tasks for completion.
So how do you know your family is a good candidate for mediation? If you and your siblings have been grappling with elder-care issues for two years or more and haven't come to any resolutions, mediation could be the answer, Goodman says. 
And while she discourages families from waiting until there's a crisis, she will offer mediation on short notice to help adult children navigate medical emergencies.
"Say the mother has fallen and broken her hip, and she is about to be discharged from the hospital, but the family can't decide where she should go," Goodman says. "Mediation offers an opportunity to have that conversation right away and make a decision."
Choosing the Right Mediator for Your Family
Elder-care mediators can come from diverse backgrounds and training. Goodman is a counselor, for example, while Pezel is a licensed clinical social worker. Doug Noll, a mediator in Clovis, Calif., is a lawyer who worked in commercial law before pivoting to mediation.
When it comes to elder care disputes, having legal expertise on board isn't always necessary, but it can come in handy in some situations, Noll says.
"There are many legal issues that can come up when we're talking about caring for elderly parents," he says. "There may be issues surrounding estate plans, durable power of attorney or advanced medical directives. Those are legal documents that a lawyer-mediator will understand."
After you decide what type of mediator you'd like to hire, there are several resources you can turn to for help finding candidates. 
First, ask your employer if family mediation is offered as a benefit. You can also search for mediators online at the Academy of Professional Family Mediators or Mediate.com. If legal matters are involved, try your state's court system. For example, New York's court system has an online directory of professionals who offer alternative dispute resolution services.
Once all siblings are on board, they often find solutions to elder-care disputes easy to reach, Noll says. "Once they understand all of the interests that need to be satisfied, the solutions are almost always straightforward," he says. "Mediation is empowering."
How Much Does Mediation Cost?
Mediation costs vary. But according to the website, A Place for Mom, private mediation ranges from $100 to $400 an hour or more.


Ways Family Mediation Can Help Resolve Elder Care Conflicts

Arlene Weintraub

Influencers — people with the power to affect others’ attitudes and purchasing decisions — have been around forever. Pope Francis has even called the Virgin Mary the first influencer. But the influencer industry has really come of age with the rise of social media.
Sylvia, then and nowThat’s not to say that the influencers themselves have come of age, however. According to one report, just 12% of Instagram influencers are older than 35 and just 1% have reached their 50s. And virtual influencers — lifelike characters who exist only online — are no more mature.
Recently, Ziv Schneider, an artist and designer who works with new and emerging technologies in nonfiction storytelling, has been exploring the intersection between influencers and aging.
In the summer of 2020, she created Sylvia, a virtual influencer whose name comes from “silver virtual influencer.” The character joined Instagram as a thirtysomething graphic designer, and she’ll age a decade per month until she reaches her 80s. Along with new photos, Sylvia's "thoughts" are shared in each new post.
Next Avenue recently connected with Schneider, a creative technologist at the Brown Institute for Media Innovation at Columbia University, to discuss the project. This interview has been edited for clarity and conciseness.
Next Avenue: Describe the virtual influencer landscape.
Ziv Schneider: Some people say that Barbie is a virtual influencer, but specifically on social media, it’s a concept that’s been around for the past three to four years.
The prime example is Lil Miquela, a virtual character that also makes music. She has millions of followers, and a lot of the virtual influencer accounts are trying to recreate that success. Miquela has done several campaigns for large brands such as Samsung and Calvin Klein.
Right now, especially with the pandemic, it’s become an opportunity for people to create virtual models that can serve as brand ambassadors and kind of take the role of an influencer.
Most virtual influencers tend to be young, right?
Schneider: I was looking at what’s out there, and I didn’t feel that I was represented in any of the characters’ designs. [Schneider is in her mid-30s.] KFC made their own virtual being that’s kind of a version of the Colonel, but if you look at the way he is designed, he looks pretty young.
"I used to be a graphic designer, so I know the concerns of individuals not having a future in the industry. It's not a work environment that favors people later in their lives."
Why create an older virtual influencer?
Schneider: You know, media and advertising are already glorifying youth, and then with virtual influencers competing with real-life influencers and real-life models, it’s like how do you compete with this so-called perfect image of a human that doesn’t age? And then why do we design age out of it?
Those questions were interesting to me to explore and to see if people would engage with a virtual influencer that represents an image that’s aging.
How did you design Sylvia?
Schneider: First of all, I learned about what it takes to produce these characters and the software that goes into creating the images. There’s a marketplace in which you can buy characters, and they’re all based on these base characters like the Genesis 3 and Genesis 8 in the Daz software that I am using. People make certain modifications, and they can sell them to you.
I found a character artist that will design her to our specific requests and can design her over different periods of time. The next step was to design a story and to think of what would make her influential in some way. I also conducted some focus groups to try and see why people follow certain influencers and also looked at a lot of influencers that already exist and the content that they’re creating.
You made Sylvia a graphic designer. Why?
Schneider: I used to be a graphic designer, so I know the concerns of individuals not having a future in the industry. It’s not a work environment that favors people later in their lives. The turnaround is just very quick, and there’s something about the work conditions that the industry has that are not something the person can do for long once they have other priorities. Another reason for making Sylvia a designer is that with virtual beings, ageism is a design issue.
How are you aging Sylvia?
Schneider: Every month, she ages a decade, so we look at references of women in that age group. The character artist designs specific details and features that really add to the character. It’s very technical.
Between certain decades, only the skin changes; between other decades, we change the body frame as well.
We also try to think about what makes sense for her story. How would she age considering her lifestyle? How do we show her facing ageism or being aged out of a job, for example, but also how do we present a positive image of aging?
What’s her story at the moment?
Schneider: She has left her workplace — the reasons for her not working there are not specified — and she’s starting her own independent consultancy. One thing we’re about to highlight in the story is that she continues to work throughout her life.
Is it correct that some of the posts are computer generated?
Schneider: If you see an image of her, I wrote that text, and it is text that is made to push the story forward or give you information about who she is and what she does.
"I had one user write to ask her about her skincare routine; I don't know what was behind that."
For every other post, we trained a machine-learning model to write text and trained it on influential Instagram accounts. And that algorithm is actually aging as well; we change the set of accounts that it’s trained on. That language actually has been pretty convincing for a lot of people to read. I think a lot of them didn’t know that it’s been automated.
Ziv SchneiderHow have people online reacted to Sylvia?
Schneider: Most respond very positively to her, and a lot of people think that she is a real human being and even express romantic interest in her…
There’s this one follower that says, like, 'Robots don’t age.' Sylvia commented, 'Well, this one does.' I had one user write to her asking about her skincare routine; I don’t know what was behind that.
What has the project taught you about aging?
Schneider: There’s something about designing a character that has an accelerated lifespan that has made me feel like my life has become a race against the clock. There’s a sense of wanting to get more done in time and kind of life slipping between your hands,  and I think that sense has accelerated because of Sylvia’s accelerated life span.
Follow Sylvia's story on Instagram.


Meet Sylvia, The Virtual Influencer

Mark Ray

When I travel, people are my nature. What excites me about travel is not the mountains, rivers, plains, trees or sunsets, no matter how majestic. What I love is connecting with people, observing people, documenting people and celebrating the wonderful diversity I see. It helps me appreciate the common threads that unite us.
"I prefer the museum of the streets, where people present themselves in their inimical, individual styles, passing by each other unawares but creating a visual feast that catches my eye."I have always loved fashion. To me, it's not only about the clothes although that is certainly part of it, but it's about the way people wear, manipulate, update, adapt, downgrade and tailor clothes to suit themselves.
Clothing has a history, and I've always loved looking at clothes through that prism.
It's about the way clothing makes you feel, and how that feeling radiates out into the world. Clothing has a history, and I've always loved looking at clothes through that prism. Museums are favorite places to see clothing in the context of history and appreciate the timeline and how fashion has evolved.
Museums of Masters
I have visited Yves St. Laurent's atelier in Paris and was awestruck by his patterns and hat forms. I've visited the Dior Museum and looked at decades of frothy designs that made me drool with envy and long for a dressing room. And I've been to the Anchorage Museum with its cases of ceremonial robes and coats made of fur and guts, enhanced with elaborate stitching and beading and evoking decades of time-honored rituals.
But I prefer the museum of the streets, where people present themselves in their inimitable, individual styles, passing by each other unawares but creating a visual feast that catches my eye. I love to note the sense of individuality and style and capture and salute that insouciance.
Streetstyle in front of the L'Arc de Triomphe, Wrapped, Paris. Common Threads
For years as a photographer I have been documenting the way people express themselves through their clothing, and how they present themselves when they step out into the world. Seeing the individuality and creativity of humans — no matter their economic status or country of origin — is reassuring.
In such divided times it confirms that people are people, and underneath our divisions we are all the same, living with our joys and challenges and doing the best we can.
Here is a sample of some of my favorite street encounters, each of which lifts my spirits. Every interaction, even if fleeting, leaves an imprint on my memory of a place and embellishes the experience of traveling.
Dressing the Environment
I remember being in Paris during the installation of Christo's Arc de Triomphe, Wrapped. I consider myself a proud groupie of the artist, having seen Surrounded Islands in Florida, Pont Neuf, Wrapped in Paris, The Gates in New York's Central Park and The Umbrellas in California.
Christo and Jeanne-Claude ambassadors in ParisThe Arc de Triomphe was spectacular not only for its shimmering coat on the Arc, revealing its shape and turning the monument into a piece of sculpture, but because of the obvious pleasure it bought to the hordes who flocked there to see it, touch it and use it as backdrop. The added element was that it was the last Christo installation, conceived before he passed away in 2020 and permitted and ready to go just as Covid closed everything.
Its posthumous installation made the Arc installation even more spectacular, something that you felt viscerally was appreciated by those lucky enough to see it in person. While I loved photographing the art, the bigger thrill was documenting the people who gathered there to celebrate it.
In Morocco, I walked through a market full of women who came down from the Rif mountains, in colorfully mismatched dresses and robes that reminded me of the cornucopia of color on Samburu women in Kenya gathered around their wells and huts. Somehow it all worked perfectly.
In Iceland, I traveled to Reykjavik in March as a birthday gift to myself in hopes of seeing the Northern Lights. Fortunately, I was able to see the lights from my airline window seat as we flew toward our destination. But while the Icelandic scenery was thrilling, I loved walking the streets of Reykjavik photographing tourists and locals.
Streetstyle in MoroccoIceland Is Cool
There I encountered Jakob, a lanky, hip young man working in a boutique while wearing super wide patched leather trousers; Norwegian high school visitors—Christopher, Juliann and Karl—dressed in replica Viking clothes they meticulously made themselves; and Resia, a young woman from China using the modernist Harpa concert hall as a backdrop for what could have been a photo shoot for her modeling portfolio. I usually stay behind the camera but couldn't refuse her request for a selfie with me — even though I was severely underdressed.
Even my very familiar hometown of New York City gives me opportunities to appreciate individual style.
In Jordan, walking the streets of Amman and visiting Petra, a World Heritage Site, I again was drawn to the people: guides dressed like Johnny Depp/Keith Richards in "Pirates of the Caribbean" were ubiquitous. Leading their donkeys on aged paths, they looked more ready to walk the plank than tour the ruins.
There were young postcard vendors plying their trade. In Amman, I followed the sound of amplified music to find a raucous wedding reception at my hotel that drew me in, and I constantly sought out fashion on the streets and in the shops.
Even my very familiar hometown of New York City gives me opportunities to appreciate individual style. From workers on streetcorners in their aprons and hardhats to models sporting the latest trends, shoppers at Bergdorf's or African queens stopping at the halal truck, the city is a rainbow of humanity.
These random meetings sustain me and allow me to celebrate the brilliance of individuals we otherwise would pass by. I'm grateful for everyone who catches my eye and becomes the subject of these very brief encounters.


A Passion for Fashion

Iris Schneider

Last December, I got rear-ended in traffic. Shortly after that, my ex-boyfriend joined my gym. These two unfortunate events, happening quickly, made me wonder if the universe might be sending me a sign: Was it time to change my workout?
Low-impact workouts like pilates and barre have deep roots in injury recovery, and can be both restorative and athleticAt 50, I'd already been questioning my exercise routine.
Little did I know that less than a year later, I'd be getting a full biomechanical workup using technology pioneered for elite athletes at a state-of-the-art movement lab. But more on that later.
At 50, I'd already been questioning my exercise routine. A dedicated runner since college and a hardcore devotee of boxing-based training since my mid-forties, I'd noticed it was taking me longer to recover from minor injuries like plantar fasciitis or a twisted ankle. 
In addition, regular activities, like driving and desk work, sometimes left me stiff and sore. Then came the fender-bender and classic whiplash symptoms:
A sharp, intermittent throb at the base of my skullNumbness in my fingersSudden stabs of pain from simple movements like turning my head or raising my armsThe pain often woke me in the middle of the night or left me unable to sleep. I'm lucky to say it was my first real experience with chronic pain. I saw a specialist who took X-rays and prescribed painkillers and physical therapy.
He also told me something that surprised me: While treatment for whiplash once involved immobilizing the head and neck, it was now recognized that this could result in permanent loss of mobility. I've never heard a more frightening sentence. Permanent loss of mobility?
Search for a New Workout
I started Googling low-impact workouts before I left the parking lot. Here's the thing about chronic pain: It's depressing. I embarked on my recovery with a negative mindset that, in hindsight, was unlike me. My search for low-impact workouts showed me few options, and I gloomily bought a three-month class package at a local Pure Barre studio, pretty sure I would hate it. 
After the intensity of boxing and running, a low-impact workout would be a huge letdown. But surprisingly, Barre turned out to be an excellent post-injury workout. It's not only challenging and strengthening but therapeutic and fun. 
Your proprioception (the awareness of where your body is in space) improves immediately and dramatically. Instructors check in with you about injuries before you start and help you modify them if necessary. Despite being low-impact, the workout is intense, and almost every move involves core strength. I began to love it.
But surprisingly, Barre turned out to be an excellent post-injury workout. It's not only challenging and strengthening but therapeutic and fun. 
My friend Elizabeth Gordon, a Pilates instructor, wasn't as surprised as I was. Low-impact workouts have deep roots in injury recovery: "It can be both restorative and athletic," Elizabeth told me. 
"Pilates is a proven prescription for stroke rehab and Parkinson's therapy. It also encourages neuroplasticity and facilitates alignment and proper posture."
That was good because, after the accident, posture was starting to be a significant concern. So in an attempt to avoid the sudden twinge of lingering whiplash pain when I turned my head, I'd started turning my entire upper body, stiff-necked. That, as it turns out, is a ticket to a new world of chronic pain. For me, it was in my shoulders, jaw, and back.
What is a 'Guarding Injury?' 
This, I learned, is known as a "guarding injury." Most active people learn early that rushing back to your exercise routine before you're fully healed leads to re-injuring yourself. But what's less obvious is that compensating – being too careful, like when you keep a joint immobile but stress your other joints – can also cause injury.
Around this time, a contact at the Hospital for Special Surgery (HSS) in Stamford, Connecticut, mentioned that HSS had launched the How You Move Lab, (HYML) a personalized fitness and wellness experience at Chelsea Piers, also in Stamford.
Musculoskeletal health is the focus at HSS; they've worked with many elite athletes, performed more hip surgeries and knee replacements than any other hospital in the United States, and have pioneered new wrist implants, tissue regeneration and repair techniques, and regional anesthesia.
I scheduled a consultation, including a visualized digital assessment and a session with mobility specialists. Upon arriving at HYML, I met with Polly DeMille, an exercise physiologist, RN, Max Castrogaleas, an exercise physiologist, and the HYML Coordinator.
Castrogaleas told me: "This is the first non-clinical setting for HSS and our first outreach to the general consumer to help reduce the risk of an injury down the line." He explained that good motion health habits should ensure that you can stay active for as long as possible.
DeMille added: "You may know already there are weak links, but the idea is to quantify, 'you can't go as low on one side, or your alignment isn't good.' You want to address those things before issues become a problem and before you start having pain or compromised performance." 
She told me not to beat myself up about my guarding injury: "The better the athlete, the better you compensate," she said.
I'd been told that HYML uses breakthrough biomechanical technology, but I needed to figure out what that would mean. So, after a quick assessment of my basic fitness level, a mobility specialist, Brandon Schneider, showed me the ropes.
The first assessment, called DARI (named after the Dynamic Athletic Research Institute, where it was developed), uses an array of infrared cameras to capture your motion as you're guided through a series of predetermined moves.
I left feeling motivated and powerful. Somewhere along the way, I'd stopped waking up in pain and started feeling energized about recovering full mobility.
The following assessment tool is a PROTEUS machine, which measures the strength and power of each movement. A specially calibrated device measures your power and acceleration as you bat, swing, chop, squat, row, lift, and execute various other moves.
Then Schneider walked me to a workstation, where my data, already uploaded to the cloud, had been compiled into a detailed digital report with an overall score and five sub-categories: Strength, Acceleration/ Deceleration, Balance and Posture, Mobility and Symmetry, and Power.
Those categories, in turn, had sub-categories: things like Core Control, Lower Extremity Tightness, Movement Education, Hip Control, and more. I'd ranked in the 95th percentile for Balance (thanks, Pure Barre!) but incredibly poorly in Thoracic Mobility (a miserable 4th percentile).
"That's my guarding injury!" I exclaimed to Schneider, who looked slightly perplexed but told me to click on any percentage for recommendations to improve my score. I clicked "Thoracic Mobility" and found two recommended exercises with animations to show how to do them correctly. The report included scores and recommendations for every single category.
I left feeling motivated and powerful. Somewhere along the way, I'd stopped waking up in pain and started feeling energized about recovering full mobility. It may sound corny, but I'd changed my mindset from negative (fear of loss of mobility) to positive (measurably improving, even optimizing my performance, in dozens of specific areas).
Now, if only I could rejoin my old gym. But, alas, there are some things even biomechanical analysis can't fix.


Improve Your Mobility for Better Fitness

Kris Herndon

Ever since my daughters entered high school, I was preparing myself for the dreaded "empty nest." While it was years away, I worried about how I would adjust to the reality of kids in college and no more time-sucking chores to do.
"Once COVID hit, all those activities came to a screeching halt and my husband proclaimed...that he could be more than happy to stay home forever,"Even though I have been a working mother in a two-income household, family always was a priority, and I was devoted to caring for our daughters. So, I did wonder how I would adjust to the hole left in my daily calendar when our girls went off to school, graduated or moved on and launched their own lives.
Here's the dirty little secret that no one talks about. . . . I can't get my husband to leave the house.
But here's the dirty little secret that no one talks about until it happens. After decades of marriage and three years of COVID quarantine, I've got a different problem: I can't get my husband to leave the house.
It's a topic of conversation among my girlfriends, all of us looking for some solitude but instead faced with our husbands, always in their sweatpants, happily hanging out around the house.
Of course, COVID was the trial run, the big disrupter, for being at home. My husband, pre-COVID, was a human tourism brochure, constantly digging up great activities we could go to. Most of them were things we did together but since we weren't holed up together at home, it didn't feel stifling.
The COVID Pivot
But once COVID hit, all those activities came to a screeching halt and my husband proclaimed that with all the books, CDs and vinyl from his youth along with tchotchkes he's collected over decades, he could be more than happy to stay home forever and read, listen to music and peruse his collections.
Maybe I have done such a good job of creating a comfortable nest that my husband just doesn't feel the need to leave. Perhaps COVID caused him to reevaluate just how important it was to get some fresh — and possibly contaminated — air.
Maybe, like so many men his age, he doesn't have enough friends — Jane Fonda has expounded on that of late, explaining to anyone who will listen how vital her women friends are to her well-being, while all men want to do is sit next to each other and watch sports or cars or women from afar. And she's right, women have friends that are soulmates, advisors, co-conspirators. Most men haven't thrown each other that emotional lifeline.
The timing is unfortunate. I'm working less than fulltime at this stage of life. Now that I've gotten accustomed to my children being gone and look forward to some time to myself, my husband has had to rethink his motivation to get out of the house every day.
Still Working, but from Home
The fact that he continues to work, but now fully from home, hasn't helped. After stressful workdays I understand that he also needs some downtime.
Guys of a certain age need a place to meet and schmooze.
Many men are at the stage of life where a decision about whether to retire is also on the table. But here is a word of warning to husbands considering that as their next chapter: Check your Rolodex for friends you want to spend time with because we can't be your constant companions.
Maybe it's a "Men Are from Mars, Women Are from Venus" kind of thing. But after watching all the episodes of "The Sopranos" for the first time recently, I feel that if only there was a Bada Bing club — without the Bada Bing. Maybe someone should start a Daddy Daycare to literally take care of Daddy.
Guys of a certain age need a place to meet and schmooze, a clubhouse where someone can make them a plate and just create an inviting space to shoot the breeze. I have no idea what they would talk about though.
Women know that building deep friendships has paid huge dividends as we all have gotten older. Long-married spouses need more time with their friends — a respite from too much togetherness at home and an opportunity to discuss something beyond what's for dinner.
I did gently mention a few weeks ago to my husband that he rarely leaves the house these days and maybe he could take an outing one afternoon a week that didn't include me.
"What do you mean I never leave the house?" he said, incredulous. "I went to Ralph's just the other day." And proud hunter-gatherer that he is, we've got the boxes and cans of unheard-of sale items we will probably never use to prove it.
Growth of Gray Divorces
I have found women are often more adventurous, even as we age. We are less willing to just hang back and "relax." For an increasing number of women, gray divorce has become a term that sociologists are noticing, as more older women have chosen to approach their senior years alone.
I have found women are often more adventurous, even as we age. We are less willing to just hang back and "relax." 
For others, independent travel is an answer. There are so many blogs, Instagram and Facebook accounts by women traveling alone that we are practically our own demographic. In my independent solo travels, I have encountered many women who got tired of asking their reluctant husbands to come along and have happily set out on their own.
Once you arrive in a strange city, it is totally liberating to explore when you don't have to check in with anyone else about what to do when, how to get wherever, or what time or what to eat each day. And it's easier to engage in conversations with strangers when you are by yourself. I find I'm more open to those encounters when I'm on my own.
Dolly Parton's Secret
I heard a story recently from a photographer who was photographing Dolly Parton. The soon-to-be-married photographer asked the performer her secret to her long marriage. Parton's answer: "Travel a lot. Separately."
While it's important to get away, for me, who never described myself as a homebody, it's essential to have some alone time that doesn't involve leaving the house. As we age, the one thing that is certain is that the future is unpredictable.
There may come a time when leaving the house is not a safe or viable option. While we are healthy and active enough, let's give each other the space to enjoy one of life's guilty pleasures — moments of solitude at home where you have a chance to think, regroup, dream and sometimes to just do absolutely nothing.
The added bonus will be that the time we do spend together will be all the more interesting, with new adventures to hear about.


Empty Nest? I Wish!

Are you constantly forgetting where you left your keys or noticing it takes you longer to remember names than it did a few years ago? You’re not alone.
More than half of adults begin to struggle with age-related memory issues by age 60, according to Harvard Medical School.
The good news is memory lapses are a normal part of the aging process — yet, that doesn’t make them any less frustrating. That’s why many research teams at renowned universities around the country are exploring how new technologies can play a role in slowing or reversing age-related memory loss.
Types of Memory
Before understanding how these technologies might work, you must first know that there are two basic types of memory: short-term and long-term.
"For a while I said TMS [Transcranial Magnetic Stimulation] is the future of psychiatry, but I realized in the last 12 months that it's the future of the brain."
“Most people will say, ‘I can’t remember what I had for breakfast — there goes my short-term,’ or, ‘I can’t remember ten years ago — there goes my long-term,’” says Dr. Harry D. Schneider, neurolinguistics consultant for the Brain Function Laboratory at Yale University School of Medicine. However, short-term memory, which makes up to 50% to 75% of what we use every day, is anything that is 30 seconds or less, Schneider says. Everything else is considered long-term memory.
“Memory begins with learning and sensing something — feeling, touching, hearing, smelling,” Schneider notes. That’s why short-term memory is also known as working memory. An example of this: recalling a seven-digit phone number that you read or heard.
On the other hand, long-term memory is anything longer than 30 seconds. Part of this is regular long-term recall, such as remembering names; and part of it is unconscious memory, or all the things you do automatically without thinking about them, like running or riding a bike. “If we had to consciously remember everything, we’d overload and stop functioning,” Schneider says.
Transcranial Magnetic Stimulation
In April 2019, Northwestern University released results of a new study that showed how one technology could help restore regular long-term recall memory in older adults to the level of that in young adults. Lead by Joel Voss, associate professor at Northwestern’s Feinberg School of Medicine, the study used a technique called Transcranial Magnetic Stimulation, or TMS.
A form of noninvasive brain stimulation, TMS works by sending electromagnetic pulses into specific areas of the brain. Voss’ team targeted a region of the brain called the hippocampus, which helps you recall two unrelated things at the same time  — for example, where you left your cell phone and your neighbor’s name.
Because the hippocampus is located too deep within the brain to stimulate non-invasively with TMS, the researchers focused on an area of the parietal lobe, which communicates with the hippocampus. Think of it like “a highway to the hippocampus,” says Schneider.
As part of Voss’ study, 16 participants age 64 to 80 who were experiencing age-related memory loss, took a memory test that mimicked real-world problems. After undergoing five days of TMS treatments, they retook the test. The results: Participants’ long-term recall memory improved to the level of a young-adult cohort of the same size, showing an average test improvement of 30 percent post-TMS.
“[The results] certainly are promising, but we’re in the early stages of this kind of technology,” says Aneesha Nilakantan, a cognitive neuroscientist and data scientist on the Northwestern team. “A lot more research needs to be done, especially around what time is best to start TMS, and long it will last.”
Alternative Uses for TMS
Voss’ study was far from the first time TMS technology has been used to stimulate the brain. Yet, it’s among the initial studies focused on memory loss. Psychiatrists around the country have been using TMS to treat depression for several years.
Dr. Ryan Wakim, a board-certified psychiatrist and president and CEO of Transformations TMS centers in Pittsburgh and West Virginia, treats patients with depression using TMS. He does this using NeuroStar Advanced Therapy, which manufactures the TMS Therapy System.
The Food and Drug Administration (FDA) approved TMS for treating depression in 2008, and for obsessive compulsive disorder in 2018. While those are the only current FDA on-label uses for the machine, Wakim sees great potential for treatments to expand in the future.
“For a while I said [TMS] is the future of psychiatry,” he says, “but I realized in the last 12 months that it’s really the future of the brain.”
Another Technology for Reversing Memory Loss
There is a slight risk — less than 0.1% — of seizures with TMS treatment. And certain factors can increase that risk, such as sleep deprivation, family history of seizures, alcohol use and a previous neurological condition, according to a 2015 article published in the journal Neuropsychiatric Disease and Treatment.
Schneider specializes in another type of non-invasive brain stimulation, called Transcranial Direct Current Stimulation, or tDCS, that has an even lower risk for seizures.
It differs from TMS in a few ways. One, it’s much more portable. The machine itself is about the size of a deck of cards, and it’s wired to two small sponge electrodes that you put on your scalp and cover up with a headband. Rather than being confined to a chair, as with TMS treatments, patients undergoing tDCS can put the gadget into a fanny pack and walk around.
Second, it works with a smaller dose of magnetism and electricity. “Imagine if you wanted to turn on a light switch, and the switch was the size of a grain of rice,” says Schneider. “You won’t feel anything, but it will begin to change some of the chemicals floating around in your brain.”
The biggest effect of tDCS is it begins to change the way your brain is wired, affecting its neuroplasticity. Think of it like a bypass, Schneider says. If one part of your brain is blocked and not working (i.e., having memory problems), tDCS can slowly build up a new neural pathway that bypasses that section.
Again, more research is needed, but there have been studies showing that strategically applied tDCS can temporarily improve thinking skills in healthy older adults, says Tracy Vannorsdall, a neuroscientist at John Hopkins Medicine in Baltimore.
However, “We are still working to determine what brain regions to target to optimize cognition in older adults, how frequently to apply tDCS and what cognitive training activities should accompany the stimulation,” Vannorsdall adds.
Non-Tech Ways to Improve Memory Loss
If you’re experiencing some age-related memory loss but not ready to seek technology-based treatment (or it isn’t available in your area), there are other actions you can take. Here are a few tips from the experts for strengthening your memory:
Don’t stress. “When you get anxious and think your memory is going down the drain, it does,” Schneider says. It turns into a self-fulfilling, yet temporary cycle. So, chill out and realize this is normal.Evaluate your diet. A healthy diet is important for maintaining good memory function. Also, a few studies have shown that restricting calories improves memory in older adults.Exercise. Vigorous physical exercise, if you are able to do it safely, is the best thing you can do for your memory. Find a way to get 30 minutes of vigorous exercise a few days a week.Try something new. Engaging in new activities that keep you socially and physically active, such as ballroom dancing or gardening clubs, are great ways to keep your brain sharp as you age.Limit alcohol. Keep consumption to, say, half a glass of wine a day or less.Learn another language. This is the single best thing for keeping your mind in tune, Schneider says, because it requires your conscious memory to work hard.

How Electromagnetic Stimulation Can Improve Memory

Kelsey Ogletree

A funny thing happens to most of us aging guys once we find ourselves near the south of 60. We start to look it. Our ears enlarge. Our bellies protrude. Our nose hairs multiply.
Take heart. There’s hope. That, at least, according to three national consultants in men’s style, fashion, and image. Sometimes it’s about what we wear. Sometimes it’s about the little things that we do — or don’t — to take care of ourselves. And sometimes it’s about attitude. Here are 14 tips to look sharp after 50:
Good Grooming
Change your hairstyle. Most older men (who still have their hair) have been getting the same haircut for decades. Same length. Same part. Same style. Time to try a totally fresh style from a new barber, says Sven Raphael Schneider, CEO of Gentleman’s Gazette, a website whose mission is to help men look like gentlemen. “Nothing dates you more than an old fashioned haircut,” he says.
Don’t hide the gray. While it’s widely believed that coloring gray hair will automatically make you look younger, that’s not necessarily the case, according to Linda Davis, USA training manager for U.K.-based House of Colour.  Most men who dye their hair do it so poorly, they actually make themselves look older instead of younger, she says. “If you don’t know coloring, it’s better to leave the gray than to color it,” Davis notes.
Trim those nose, ear and wild eyebrow hairs. Every man over 50 knows that the fastest growing hair on his body tends to be in those exact places where he doesn’t want it to grow. Regularly trimming those hairs with a specialty trimmer can also trim years off your looks, says Schneider.
Invest in quality skin care products. Many men over 50 are seeing age spots and even dealing with skin cancer. Finding and using top quality skin conditioners and moisturizers can add life to your skin and slow the aging process, says Antonio Centeno, founder of the website Real Men Real Style.  The soap you use for your face should be specifically designed to gently wash and moisturize, and different than what you’d used in the shower, he adds. And don’t forget to use sunscreen daily.
Keep those pearly whites shining. Particularly if you’re a smoker or heavy drinker, it’s critical that you get yellowing teeth whitened, says Centeno. Few things signal aging more than discolored teeth and sour breath. “You need to take oral hygiene very seriously,” he says.
Grow a stylish beard. Short beards that are very neatly trimmed can be more a sign of youth than a sign of age, says Schneider. But this probably won’t work if your beard is white — or very curly. “Ungroomed, Santa Claus beards won’t work,” he says.
Cue the Cooler Clothing
Bag the baggy jeans. Which one of us can’t plead guilty to owning at least one pair of jeans so baggy and rumpled they could be mistaken for something Mr. Green Jeans wore on Captain Kangaroo?  “You can’t wear the same pair of jeans that you wore twenty five years ago,” says Davis. Jeans with more fit — and more fashion — can immediately help you look younger, she says.
Purchase quality clothing. Wearing quality clothing that is fashionable sends a message of youthful authority, says Centeno. Next time you head to Starbucks for a latte, he suggests, instead of wearing your torn T-shirt and faded sweatpants, put on a snazzy shirt and fashionable slacks and you’ll immediately notice that people are looking at you (and treating you) differently.
Buy one very expensive suit. The true value of clothing isn’t what it costs when you buy it, but how often you wear it — and how you feel in it, says Centeno. A suit that costs $1,000 is something you might be able to wear more than 100 times. And it's one you’ll likely get compliments on every time you wear it. Compare that to an ill-fitted $100 suit that makes you look older and that you find all kinds of reasons to avoid wearing.
Consider getting a color analysis. Wearing the right colors can make all the difference in the world, but that can require getting a personalized “color analysis” from a fashion consultant which can definitively determine what colors look good on you. Generally speaking, red is a color that makes most men look younger. Surprisingly, purple tends to be a good color for most guys, too, says Davis.
Add to Your Look
Dump the metal-frame glasses. It’s okay to wear glasses and still look young. But wearing gold- or silver frame glasses will immediately make most guys look older than they are, says Davis. She suggests getting fashion glasses — ideally with a serious splash of color — to shave years off your looks.
Watch those watches. Standard gold and silver watches instantly make you look older, says Davis. No single piece of jewelry makes you look older than wearing a Seiko watch with the gold and stainless steel mix, says Schneider. As he adds, wearing an Apple watch can make you look younger because the technology screams of youth.
Dump the Velcro sneakers. Velcro tennis shoes — particularly when the sneakers are all-white — is an “old people look,” says Schneider. He suggests mixing things up with brown, black or even colorful sneakers. And while you’re at it, consider no-show socks (particularly with sneakers). If your socks show, make sure they have a burst of color.
Consider a tattoo. Few things signal youth faster than strategically placed tattoos. “This is what young people do,” says Schneider.


Sharp Style Tips for Men 50+

Bruce Horovitz

A common criticism of the Unretirement movement (people earning an income during the traditional retirement years) is that it’s a fine idea for office workers and white-collar professionals. But blue-collar workers? Hardly.
Turns out, that conventional wisdom is flat wrong and many workers who’ve gotten their hands dirty during their careers are proving it.
In my research for my book, Unretirement, and since then, I’ve learned that quite a few people are staying with —or turning toward — blue-collar part-time work in their Unretirement years, and with good reason.
(MORE: Secret to Retiree Happiness)
Blue-Collar Jobs In Unretirement
These days, machines do much of the heavy lifting. The tasks performed by blue-collar workers employed full-time or part-time increasingly involve high-tech gear and brainpower rather than brawn and physical endurance. The jobs are often engaging.
Take Stan Kulceski, 77. He went into machining after attending a vocational high school in Pittsburgh, Pa. and picking up additional skills in night school. Kulceski worked in all kinds of machine shops and tackled various machining jobs during his long career, from repairing power turbines to operating mold making plastic injection systems. He “enjoys working with my hands” and delights in the “the math.”
(MORE: 10 Sites to Find Part-Time Work)
Kulceski retired at 68 when the company he worked for was bought out. Now, he instructs others 12 hours a week at New Century Careers, a Pittsburgh-based nonprofit that develops local entry-level machinists.
“I never thought I would teach,” says Kulceski. “I feel that for every student, I’m giving them something they can rely on to make a living and helping keep the industry in the U.S.”
Kulceski also works at Costco one or two days a week, usually on the weekend, handing out food samples to customers. “I love that job,” he says.
Passing On Knowledge to a New Generation
David Lowe, 66, is another long-time machinist who’s now passing along his love of the trade. After nearly four decades as a machinist, Lowe was laid off in 2012, due to an acquisition. “I retired for a year,” he says. “I got antsy. I wanted to do something.”
Aside from being a councilman in Mount Oliver, a community in South Pittsburgh, Lowe puts in time at New Century, mostly talking with students. “I’m what they call, a ‘substitute substitute,’” he says.
(MORE: 10 Things Retirees Won't Tell You)
New Century’s instructors have typically worked 40 to 50 years full-time before turning to teaching part-time. “They had a great life and they want to pass it on,” says Paul Anselmo, founder and head of New Century Careers.
Blue-Collar Boomerang Mentors
Some industrial companies are also realizing that their retired skilled workers are valuable mentors. For example, Tennant Company, a Minnesota-based designer and manufacturer of floor maintenance equipment, scrubbers, sweepers, buffers and the like brings back some of its retired technical workers (welders, fabricators, powder coat painters) through flexible schedules. Tennant’s blue-collar boomerangs don’t get benefits, but they earn essentially what they were making previously on an hourly basis.
“They are high-skilled labor, they know our processes and they can mentor and bring along our more junior operators,” says Beth Braun, senior human resource manager for global operations at Tennant.
But isn’t this backbreaking work? I asked. Not really, the aptly-named Braun said. Yes, there are physical demands, “but a lot of the work is technical, sitting in front of a computer and programming a laser machine to cut sheet metal, for example,” she notes.
On the Road Again
And keep on truckin’ could become an Unretirement theme. More than a fifth of long-haul truck drivers are 55 to 65 and many are on their second or third careers, according to Rob Reich, senior vice president of maintenance and driver recruiting for Schneider, the transportation company headquartered in Green Bay, Wisc.
Long-haul trucking is still a demanding job, of course, involving more than its share of frustrations and risks. (Imagine skiing on 18 wheels through the Pennsylvania humps and bumps during the winter, one industry expert told me.) But the job is also getting easier in some respects. The industry is making a transition toward automatic transmissions, far less demanding physically than manual transmissions. All the roughly 2,000 trucks Schneider will buy this year will come with automatic transmissions.
Schneider and other trucking firms welcome older drivers, including couples. If both qualify to drive, they may be assigned together in a “lifestyle team,” a potentially attractive option for empty nesters. “We’re very flexible with their schedules,” says Reich. “That’s one reason it’s a good second or third career.”
Richard Wagner, who runs Dunwoody College of Technology, a trade school on the edge of downtown Minneapolis, told me that older students are coming there to get a certificate that keeps them employed.
Some older electricians, weary of climbing up and down ladders and lugging heavy equipment, get qualified to become estimators on the electrical work for projects, for example. “Former electricians are really good estimators,” Wagner says.
With a bit of creativity, there are plenty of Unretirement opportunities in all kinds of jobs: blue- and white collar.


Blue-Collar Jobs Work Well in Unretirement

Chris Farrell

There’s one question many people in their 40s, 50s and 60s have when they muse about switching from their current occupation into an encore career that will let them have a second act with a social purpose: How do you do it?
 
That’s been a toughie, since no one had created a practical guide for people eager to make the midlife shift. Until now.
 
A How-To Book for Encore Careers
 
Marci Alboher, one of the nation’s foremost experts on this subject, has just written The Encore Career Handbook, and I can’t recommend it strongly enough if you’ve got the encore itch.
 
(MORE: The Boom in Job Seekers Looking for Encore Careers)
 
“The most popular question I get is, ‘It’s hard enough to find work today; how can I also find good work that’s going to do some good in the world?’” says Alboher, 46, a New York City-based vice president of the nonprofit Encore.org, whose mission is to “promote second acts for the greater good.” (Next Avenue has articles and videos from Encore.org on our site.)
 
Her answer (aside from “buy my book,” she jokes): “I concede it’s very hard to find work now, but the things that will allow you to find work will also allow you to find work with a social purpose. It’s really no harder.” 
 
Nine million people ages 44 to 70 are in encore careers today and an additional 31 million are interested in joining them, according to Encore.org’s research.
 
Create an Encore Resumé
 
One key to finding encore work is to create what Alboher calls your “encore resumé,” which is different from a standard resumé.
 
It doesn’t list your entire career history, just the parts that would be relevant when seeking an encore job. Unlike a regular resumé, an encore resumé might prominently highlight your volunteer work.
 
“You want to present yourself as someone who has amassed valuable experience and wants to put it to use to matter in the world,” Alboher says. Her book provides three sample encore resumés so you can see what one should look like.
 
(MORE: 7 Reasons Volunteering Can Lead to a Job)
 
No Instant Makeover
 
If you think launching an encore career will be a cinch, however, Alboher wants to set you straight.
 
“It’s not quick and it’s not easy," she says. "That’s the message of my book. I am not a fan of the idea of an encore transformation as an instant makeover. I’ve lived through a career transition myself and talked to hundreds of others who have, too. I want to dispel that myth.”
 
Though Alboher isn’t in an encore career herself yet — she is, however, “planning one” —  she has hopscotched fields twice. Originally a lawyer, Alboher gave that up to become a journalist, author and writing coach, including stints writing about work for The New York Times and Yahoo! She switched to the nonprofit world in 2009, when she joined Encore.org.
 
3 Encore Career Myths
 
Three other myths Alboher wants to dispel:
 
1.You need to save the world with an encore job. “You don’t,” Alboher says. “Lower your bar.”
 
2. You need to be wealthy to launch an encore career. Alboher’s response: “Hooey.” She does, however, recommend you meet with a financial planner before embarking on an encore career, to see if you can afford to make the switch. Alboher’s a fan of the Life Planning Network, professionals dedicated to helping people navigate the second half of their lives. You can search on its site for local planners who are members.
 
3. An encore career requires taking a vow of poverty. Actually, she says, it’s about “making a difference and making a living, not purely altruistic ventures or volunteering.”
 
One of the most useful parts of the book is what Alboher calls “The Encore Hot List.” It has descriptions of 35 types of encore jobs and their average pay in the fields of health care, social services, counseling and coaching, as well as education, nonprofits and the green world. The positions are expected to be in high demand and offer opportunities for flexible or part-time work and self-employment.
 
(MORE: Have Patience When Considering an Encore Career)
 
Alboher is brutally honest about these, noting that some pay quite well (average annual pay for a physician's assistant: $89,470) and others, like adjunct professor, pay very little (roughly $3,000 per course). “Adjunct is the perfect word,” Alboher says. “The work is very gratifying if it’s an adjunct to what you do. But if you rely on being an adjunct professor for your entire income, it’ll be very tricky.”
 
Where to Get Personal Assistance
 
If you’d like personalized guidance to get your encore career started, Alboher has three suggestions:

		Click on the Encore Community map on the Encore.org site to find local groups dedicated to this mission around the country.
		Join the Encore.org LinkedIn discussion group and throw out questions to its 1,746 members.
		Speak directly to her. If you buy Alboher's book and email the receipt by Jan. 1, you’ll be able to sign up for her free “virtual advice” online session Jan. 7. “I’m really interested in hearing what people who want to start encore careers are struggling with,” Alboher says.
If anyone can figure out how to overcome obstacles at the start of your second act, I think it's Marci Alboher.


A Manual for Encore Careers

Richard Eisenberg

In nursing school, our instructors warned us over and over again to watch our backs. Every anecdote seemed to end with some nurse getting back surgery.
But as carefree twentysomethings, almost none of us listened. I yanked heavy patients up in bed by myself, rolled people back and forth to change dressings solo, and was generally hesitant to ask for help.
Surgery is a viable option, as are medications, but the treatment for back pain is steering more and more toward rehabilitation through physical therapy.Fast forward 14 years. At seven months pregnant, after a difficult code on my unit, I herniated two lumbar discs and spent two days in the hospital. I came home with a walker, a shower chair and a toilet riser. It was a humbling reminder that my nursing instructors had always been right.
For a long time, I thought I would feel broken forever. I did not want back surgery unless it was unavoidable. Surgery is a viable option, as are medications, but the treatment for back pain is steering more and more toward rehabilitation through physical therapy. 
Up to 84% of adults will experience back pain at some point. So let's talk about how to beat it back.
Physical Therapy 
According to the Journal of Orthopaedic & Sports Physical Therapy, exercise and manual therapy are the best medicine for chronic back pain. The Mayo Clinic states the causes of back pain can include:
● Ankylosing spondylitis
● Arthritis
● Muscle and ligament strain
● Osteoporosis
● Ruptured or bulging vertebral discs
Per Mayo, many of these can be prevented and treated with exercise and flexibility training. Take herniated discs, for example. Your spinal discs cushion your vertebrae – backbones – and can sometimes shift out of position, pushing against nerves and causing pain. Stretch and strengthening exercises can coax the disc back into place.
The best way to make PT work for pain control is to make the exercises a part of your daily life.
Using the McKenzie Method, says Loren Fishman, MD, medical director of Manhattan Physical Medicine and Rehabilitation in New York, "people with herniated discs arch their backs, creating a partial vacuum at the form of the vertebrae which draws the herniated part of the disc forward and away from the nerves."
Physical therapy can heal a bulging or ruptured disc and other similar injuries throughout the body. You can use exercises, says Fishman, to move a joint back into alignment and to soothe and stretch spasming muscles.
By far, physical therapy (PT) has helped me the most. Seeing a physical therapist can be expensive, but once you know the exercises, you can keep doing them at home at no cost. The best way to make PT work for pain control is to make the exercises a part of your daily life.
Yoga
Fishman often encourages patients to use his favorite treatment: yoga. "Innocuous, almost free, effective, no downtime and best of all: people can keep doing it all their lives," he says, and notes yoga can also provide "better posture, better balance, greater strength and range of motion, refined coordination and lower anxiety."
You can modify yoga poses to suit your needs. Modifications will either reduce the intensity of an exercise or change its focus. For example, if you have lower back pain, you could try sitting on a folded blanket or chair to reduce the strain on the painful area.
Cold and Heat Therapy
Cold works better than heat for back pain, explains Fishman, because heat opens your blood vessels, and the first thing they do is carry heat away from the sore spot. "Cold contracts those blood vessels," he notes, "and so it penetrates and is a good anesthetic."
My physical therapist advised me to alternate heat and cold. I have found heat is good for the mornings when I'm stiff, and cold works best after I've exercised my back or if it's sore a bit into the day. Both cold and heat can help with pain and swelling, according to Mayo Clinic, when applied for 15-20 minutes at a time.
Massage
This is where the "manual therapy" mentioned above comes in. Sometimes I'd walk into the PT clinic, and my therapist would take one look at me before telling me to lie down. I expected PT to be something like "The Biggest Loser" competition, with a burly therapist yelling at me to "work harder!"
Muscle strength gave me back mobility, and now I'm hooked.
But many sessions included manual therapy. According to Mayo Clinic, this therapy involves a physical therapist repositioning muscles, tendons, and nerves. It mostly felt like a deep tissue massage and helped every time.
My therapist also taught me how to use a tennis ball at home to work out knots in my back. A study published in 2023 in The Journal of Nursing showed the tennis ball method can help relieve nurses' back pain and offers an easy and inexpensive method of pain control.
Medication
When you have a sudden fierce pain in your back, you only want someone or something to make it stop. But unfortunately, many call urgent care or ERs, saying, "Give me the good stuff!" And while pain medication, especially narcotics, can help in a critical situation, they aren't a long-term answer.
Some commonly suggested back pain medications include:
● Antidepressants: This category of medicine might raise your eyebrows, but they can treat pain by changing how your brain perceives it.
● Anti-seizure: Seizure medications affect the nerves, so this group might work best for you if your pain is nerve-based.
● Muscle Relaxers: Medicines in the muscle relaxer category don't work on your muscles, but on your brain, according to Cleveland Clinic. They help the brain to stop muscle spasms, thus preventing pain.
● NSAIDS: Non-steroidal anti-inflammatory medications (NSAIDS) offer an over-the-counter option for people with back pain. Tylenol (acetaminophen) and Advil (ibuprofen) fall into the NSAID category and can be effective for acute pain.
● Narcotics: Opioids like morphine and oxycodone fall into this category. These medications offer effective pain control short-term but are habit forming and stop working as well if taken over a long period.
Let your provider know if you want to try a medication for your back pain. I still occasionally use a muscle relaxer or an NSAID, but over time I've needed them less and less.
Steroids or Surgery 
Sometimes, despite everyone's best efforts, pain doesn't resolve with exercise or medications. You can speak to your health care provider about steroid injections or surgery.
"If PT, yoga, and time itself don't relieve the pain," says Fishman, "then the pain from herniated discs often resolves with epidural steroids." However, he notes that steroid injections can be less effective for other pain-causing conditions, like spinal stenosis.
One of the most severe complications of a back injury is nerve damage.
No one can tell you when to have back surgery. That decision is a team effort between you and your health care provider. If you decide surgery is the right option, you have many more choices than you used to.
A microdiscectomy, for example, can treat herniated discs with minimal recovery time, says Fishman, and "newer treatments for spinal stenosis are quite a bit better than the standard fusion." Your provider can help you understand all your options and advise which might be best for you.
When to Call a Doctor
When I was in the ER, every doctor and nurse that walked in asked me about my bladder and bowel control. While it may seem like an odd question, one of the most severe complications of a back injury is nerve damage.
If you find you can't urinate, that you eliminate waste without knowing it, or have numbness that ascends from your feet toward your knees, it may be a sign your nerves are involved. In this case, you might need a more urgent treatment plan. 
Seek out medical care right away, per Cleveland Clinic, if your back pain is paired with the following:
● Bowel or bladder problems
● Fever
● Pain that doesn't get better after about a week
● Pins-and-needles, pain, weakness or numbness in your buttocks or legs
● Unexplained weight loss
I went from needing help getting out of bed to shoveling mulch for hours and had a baby in between. The journey was long. It's been almost three years, and I still notice pain when I lay off my exercises. But muscle strength gave me back mobility, and now I'm hooked.


5 Techniques to Relieve an Aching Lower Back

Abby McCoy

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